Lithium maintenance: 1. A standard education programme for patients

Article Abstract:

An interactive process of learning has proven to be the most beneficial when providing health education to patients. Programs must be tailored to the target population as well. The factors to consider are not only the topics and the method of presentation, but socioeducational level of the patients and personalizing treatment schedules to fit in with the patient's routine. Audiovisual material has proven more useful than written material. Patients taking lithium seem to be at particular risk for relapse due to noncompliance with medication schedules, which is thought to account for 75 percent of relapse. A research protocol was designed to educate patients being maintained on lithium about the importance of compliance. The program included a 12-minute videotaped lecture on how lithium is used, graphic illustrations, and an illustrated transcript of the lecture. There were 60 subjects, half of whom were assigned to an educational group and 30 of whom were controls. All were given a Lithium Knowledge Test (LKT) at the beginning of the study and a Lithium Attitudes Questionnaire (LAQ). At the second visit six weeks later subjects were retested and the education group saw the videotape. A home visit followed for patients in the education group, at which time questions were answered. These patients were retested with the LKT as well. Six weeks later all subjects were again tested with both questionnaires and the control group was given the educational series. At the end of the study six weeks later, all subjects were tested for a final time. Results showed that while the two groups began the study with similar test scores, scores improved significantly more for the educational group after the first six weeks than for the control group. Controls also improved after administration of the program. This suggests that a relatively simple educational program, using audiovisual and written material, can significantly educate patients and lead to attitude changes regarding their treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Usage, Patient compliance, Patient education, Lithium, Lithium (Metal)

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The psychiatric symptoms, diagnoses and care needs of 100 mentally handicapped patients

Article Abstract:

In the last decade there has been a substantial decrease in the number of mentally handicapped individuals placed in long-term care in hospitals. This is largely due to deinstitutionalization and a move to provide community care for many of these individuals. In order to understand the link between mental handicap and psychiatric illness, and the need for inpatient versus community residential long-term placement of these patients, 100 patients were randomly selected from a hospital population. Nursing staff were asked to report on behavioral problems during the week prior to the study, each patient underwent a psychiatric interview, and health care and residential care needs were identified from professional evaluations. Patients included 55 men and 45 women with a mean age of 43.2 years. Average hospital stay was 24.4 years. Sixty were receiving psychiatric medication. Fifty-nine patients were rated as having at least one pathological behavior problem, and 80 were psychiatrically diagnosed. Only 30 percent were rated to be in need of long-term care in a hospital, but 85 percent were in need of specialist care. All but one was rated as needing residential care, but for only 31 was this judged to be a mental handicap hospital. Most of these displayed more severe psychiatric disorders than the rest. Statistically, it is recommended that there be 30 long-term hospital beds available per 100,000 population in order to properly care for those who require long-term hospital placement. The rest can be cared for in residential care programs in the community and in less restrictive environments when possible. Staff availability in the community is an important prerequisite, however. (Consumer Summary produced by Reliance Medical Information, Inc.)

Statistics, Mental illness, Mental disorders, Deinstitutionalization

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